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Pain Management 2019 & Internal Medicine 2019
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 40
JOINT EVENT
7
th
Edition of International Conference on
Pain Management
8
th
Edition of International Conference on
Internal Medicine &
Patient Care
&
March 25-26, 2019
Rome, Italy
Ryan Duffy et al., Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-006
Chloride-restrictive fluid resuscitation of septic patients
Ryan Duffy, Dan Smith, Susanti I Ie, Jonathan Nogueira, Mahtab Fo-
roozesh
and
Anthony Loschner
Virginia Tech School of Medicine, USA
Patients with sepsis often require large volumes of
intravenous fluids during resuscitation. Historically,
normal saline (NS) has been the default fluid for these
patients. However, the composition of NS does not
reflect physiologic concentrations of electrolytes and
recent studies have associated NS administration with
increased risk of hyperchloremic metabolic acidosis
and kidney injury. In 2015, our institution’s Emergency
Department (ED) began using normosol, amore balanced
crystalloid as their default resuscitation fluid. We
performed a retrospective before and after cohort study
of all patients admitted through our facility’s ED with a
diagnosis of sepsis, severe sepsis, or septic shock during
two six month periods, when either NS or normosol
was used as the default resuscitation fluid. Regression
modeling controlling for baseline characteristics and 24h
fluid intake volume found no differences between groups
for the primary outcomes of acute kidney injury (P = 0.99)
and renal replacement therapy (P = 0.88). Patients in the
Normosol TM-R cohort were found to have a lower rate
of hyperchloremia at 72 h post admission (28% vs., 13%,
P<0.0001).
Biography
Ryan Duffy has completed his Bachelors in Science from Ap-
palachian State University. He is currently a fourth year medical
student at VirginiaTech Carilion School of Medicine, a research
intensive medical school in Roanoke, Virginia. After obtaining
his MD in May, he will begin his residency training in Internal
Medicine in June 2019.
duffyra@vtc.vt.edu